The June 24 issue of The Wall Street Journal carried a front-page article introducing readers to the radical idea that a nursing home could be a place where you or a loved one might want to live, not just a place in which to die. The story followed one of the industry pioneers, physician Bill Thomas, who developed an elder care model called Green Houses. Step into a Green House and you step into a small, tight knit community of 10 to 12 residents and their caregivers, where people live together in a ranch-style home in an atmosphere that’s more like a family than a facility.

What the Journal article did not mention was that not only are Green Houses improving the lives of the elderly who live there, but they also are transforming the workplace of the aides who care for the residents. For the workforce management perspective on nursing homes, I turned to Beth Baker’s Old Age in a New Age: The Promise of Transformative Nursing Homes, an engaging, compassionate and well-researched book that anyone who plans to live beyond 80 would benefit from reading. The book landed in my inbox a day before the Journal article, so I welcomed the chance to offer a workforce management response to a promising development in the $122 billion nursing home industry.

Baker’s book includes a chapter on the dire workforce shortages, high turnover and poor working conditions of nursing homes, all of which have contributed to their reputation as destinations of last resort. Most HR executives know well enough our nation’s shortage of nurses. And many know of a similarly looming shortage of nursing home aides, a crisis that is expected to grow as baby boomers age. With the help of hard stats and previous research, Baker frames this issue in no uncertain terms. Turnover among aides—the people who are the homes’ frontline workers—is 70 percent nationally and 100 percent in 10 states. Annually, staff turnover costs the average nursing home $150,000, while absenteeism adds another $75,000, Baker writes. Nationally this waste in the system totals an estimated $4.1 billion, of which $2.5 billion is paid by taxpayers through Medicare and Medicaid.

Nursing home aides have said in previous studies that the working conditions that are most important to them are having enough staff to care for residents, being treated with respect, working as a team and having a good relationship with supervisors. For reasons that have to do with regulation, economics and entrenched interests, nursing homes have been slow to change, let alone transform themselves. But, as Baker writes, it is transformation that is necessary if nursing homes are to attract and retain workers who, in turn, feel empowered to care for and contribute to the lives of residents.

Enter the Green House. In 2004, Baker visited a transformational nursing home, one of Bill Thomas’ Green Houses, in Tupelo, Mississippi. Here nursing aides are called shahbazim. Thomas borrowed the word from the Farsi word shahbaz, meaning “royal falcon,” an image that evokes courage, loyalty and strength. He likens them to “midwives of elderhood.”

Interestingly, the word shahbaz, however foreign, has helped give new life to the job. Baker wrote to me in an e-mail: “When the first Green House opened in Tupelo, they ran an ad for a CNA [aide] to work in an innovative setting. They got 2 responses. When they ran an ad for a Shahbaz they got 70 responses. Such is the power of language!”

Rather than being the bottom rung in a hierarchy, shahbazim are in put in charge to “protect, sustain and nurture” the elders for whom they care. They are the head of a household of 10 to 12 residents, far fewer than the 20 or more residents nursing aides normally care for. They are trained to be both caregivers who help residents dress and wash and homemakers. The shahbazim cook three meals a day for the residents and deal with their everyday needs, desires and problems. For their domestic efforts, the aides are paid more. They have more responsibility and feel better about themselves and their employer, Baker writes. Nurses, doctors, therapists and social workers make house calls, and in doing so, they become members of a team who bring their services to people, rather than being the top of a social hierarchy in which nursing aides are at the bottom. Baker describes meeting one shahbaz, Rena, an 11-year veteran of nursing homes:

“As we talked, she puttered around the kitchen with a proprietary air. On the counter were bowls of fruit, chips, a layer cake, and a cookie jar. Part of her training includes cooking; many of the young women grew up on fast food and had few culinary skills before becoming shahbazim. Rena kept a watchful eye on Mrs. Adams, who was finishing her meal at her own slow pace.”

Baker shows other examples of nursing homes combating turnover by giving workers career advancement opportunities, a strategy similar to Workforce Management Optimas Award winner Sun Healthcare.

But the transformation of work and place is most evident in Thomas’ Green Houses. The power to make decisions and to care for residents is in the hands of aides who no longer feel mistreated, disrespected or unable to do their job.

HR executives and other business-minded readers, of course, want to know the return on such an investment. Does it reduce turnover and eliminate wasteful costs? Baker reports that turnover at the Green House in Tupelo dropped by 10 percent. Another nursing home in Rochester, New York, saved $4 million a year in temporary worker costs by including certain principles advocated by Thomas. A shortage of extensive data on Green Houses should change. As The Wall Street Journal reported, Thomas recently received a $15 million investment from the Robert Wood Johnson Foundation to build Green Houses throughout the country and study their impact. Perhaps only then will we know whether these nursing homes are as transformational as they seem.

Edward Lawler starts out his new book, Talent, discussing how sick he is of hearing executives give lip service to their employees with nothing to show for it.

“Time after time I have heard senior managers say, ‘People are my organization’s most important asset’ or ‘Employees are number one in my organization.’ Sounds good, but in many organizations, there’s an enormous gap between the rhetoric and the reality,” Lawler writes.

So Lawler, who is the director of the Center for Effective Organizations at the University of Southern California, spends the next 242 pages describing what processes and procedures companies need to put in place to create what he calls a “human capital centric organization.”

There is a lot in Talent that you may have heard before: how to make sure you have the right HR people in place (business partners versus administrative staff); how to implement an effective performance management system (that evaluates and motivates); and how to develop your managers so that they are leaders and managers.

This is all important stuff. However, there was one chapter in Talent that I found to be really new and interesting. That was the chapter about corporate boards and talent management.

Often when we think about boards of directors we think about a room of former CEOs and finance guys who go over numbers and compliance issues. That’s pretty much what Lawler has found in his research as well.

But if a company wants to really use its people as its competitive advantage, then these boards of directors have to be informed on the talent management issues within the company. Not only that, but at least some of these board members should have some HR expertise—which, according to Lawler’s research, is a pretty rare occurrence.

Most of the time, former CEOs are the go-to person on the board about talent issues.

“There is no doubt that many CEOs have some understanding of the human capital issues that corporations face, but they rarely have the kind of in-depth expertise that a professional in HR could bring to a board,” Lawler writes.

If boards rely on finance experts for financial matters, why wouldn’t they have HR experts for human capital issues? he asks.

To address this issue, boards should not just seek out HR experts to join them as members, but they should also participate in training sessions on talent management issues, Lawler says.

While boards often undergo training on compliance and finance issues, they don’t do anything with regard to talent management. This is really a problem considering it’s the board’s job to make sure companies have proper succession planning processes intact. How can they oversee this if they don’t fully understand it?

Lawler suggests that boards assess their companies’ talent by acting as “mystery shoppers,” either by dropping by companies and chatting with employees or watching focus groups.

Lawler proposed that boards set up “human capital committees” to delve into these issues.

But probably the most controversial suggestion that Lawler makes when it comes to boards is to have board members go through performance reviews in the same formal way that executives should be evaluated.

He notes that more than 80 percent of board members say they do an effective job. But most of these individuals are evaluated informally.

Lawler described how he once asked a board chair about this, and the chair suggested it would be insulting to establish a formal evaluation for board members considering the amount of time they are giving to be on the boards. But, as Lawler points out, aren’t these individuals being paid hundreds of thousands of dollars to be on these boards?

I think Lawler is right in saying that a company that really focuses on talent management should have a board of directors that does the same.

I don’t think that his vision will become the norm anytime soon, however. Particularly in the wake of Sarbanes-Oxley and SEC rules on executive compensation, boards are busy enough with financial matters to take the time to focus on talent management.

Maybe I’m just a skeptic. What do you think?

 Listen to a Workforce Management Podcast with Edward Lawer.  Link opens a 2.25 MB MP3 file.